The focus of this article is the retention of nurses in acute care settings in hospitals in Australia. It is acknowledged that hospitals are operating in a competitive labour market, as nurses are in demand worldwide, therefore retention of experienced nurses is an issue of the highest priority for health service managers.
There are few occupations that have attracted as much interest with regard to supply and demand as professional nursing. There have been regular media reports of nursing shortages and headlines of 'the nursing crisis', as well as a number of State and Federal Government reports into the labour market for nurses (Australian Health Workforce Advisory Committee [AHWAC] 2004; Auditor General, Victoria 2002; Department of Health and Services, Tasmania 2001; NSW Health Department 1998).
This article acknowledges the importance of strategic human resource management (HRM) to the success of retention of nurses in acute care settings in hospitals. HRM performs a strategic function, focusing on the long term, linking business and HRM strategic objectives and forward planning. Kaye (1999) endorses the belief that an organization's effectiveness will be enhanced if human resource considerations are taken into account when selecting business strategy.
Nursing forms the largest body of employees in the health care system, spanning all segments of care. A shortage of nurses jeopardizes many aspects of health care delivery. Therefore nurse employees are valuable assets to health organizations and their services need to be maintained to ensure quality health care is provided to consumers.
This article will discuss issues related to the nursing shortage and provides a literature review of Australian state and territory government reports into the retention of nurses and a strategic HRM approach to the management of nurse employees.
ISSUES RELATED TO THE NURSING SHORTAGE
The shortage of skilled nurses in acute care settings in hospitals is not only an Australia wide problem but a problem globally, as the mobility of nursing qualifications facilitates travel both locally and internationally.
Nursing shortage in the acute inpatient setting
The Queensland Government Ministerial Task-force Report on Nursing Recruitment and Retention (1999: 53) found 'there is a 20.2% turnover of permanent nursing staff in Queensland each year'. 'In Victoria there are 70,000 nurses with 56,000 working in the system and about 2000 dropping out every year' (Witham 2000:9). The Australian Nursing Federation (ANF) Tasmanian delegate conference (2000) highlighted that Tasmania has an additional problem with retention of nurses, as the average age of Tasmania's nurses being older than the rest of Australia, with a very large group due to retire over a 10 year period. The ANF conference also discussed Tasmania's nursing school enrolments, showing they are down by 19%, with the number of part time nurses up by 44% and the number of nurses over 40 years of age averaging 65% (ANF 2000). The AHWA (2004: 14) 'estimates a nursing workforce shortfall over a ten year period of 60,799 nurses, with the gap estimated at 5,504 in 2006 and 8,329 in 2012'. According to the National Review of Nursing Education of 2002, if measures are not taken to improve the national nursing shortage there will be a projected shortfall of 31,000 nurses by the year 2062 (Armstrong 2003). An article on the retention of nurses in the Australian workforce by Armstrong (2003: 16) states:
This is one of the greatest challenges the Australian health care system has faced and one that can be overcome if nurses are respected for the professionals they are and rewarded with the pay and conditions that reflect this.
The health care system is facing a critical nursing shortage, particularly in the acute inpatient setting (Upenieks 2003; AHWAC report 2004; Australian Capital Territory [ACT] Health Workforce Plan 2005-2010; Dockery 2004; Department of Health 2004; Queensland Health Systems Review 2005). …